This is the first book to examine individual rights from an economic perspective, collecting together leading articles in this emerging area of interest and showing the vibrant and expanding scholarship that relates them. Areas covered include The implications of constitutional protections of individual rights and freedoms, including freedom of speech and of the press, The right to bear arms, The right against unreasonable searches, The right against self-incrimination, The right to trial by jury, The right against cruel and unusual punishment, (...) including capital punishment. The focus of these papers is both theoretical and empirical, examining how economics can illuminate the entire sequence of crime and punishment, from the decision to commit a crime, to police methods for apprehending and arresting criminals, to the rules used in trials to the scope of punishment for the convicted. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

The concept of fitness is central to evolutionary biology. Models of evolutionary change typically use some quantity called “fitness” which measures an organism’s reproductive success. But what exactly does it mean that fitness is such a measure? In what follows, we look at the interplay between abstract evolutionary models and quantitative measures of fitness and develop a measurement-theoretic perspective on fitness in order to explore what makes certain measures of fitness significant.

This article argues that we could improve the design of research protocols by developing an awareness of and a responsiveness to the social contexts of all the actors in the research enterprise, including subjects, investigators, sponsors, and members of the community in which the research will be conducted. ?Social context? refers to the settings in which the actors are situated, including, but not limited to, their social, economic, political, cultural, and technological features. The utility of thinking about social contexts is (...) introduced and exemplified by the presentation of a hypothetical case in which one central issue is limitation of the probability of injury to subjects by selection of individuals who are not expected to live long enough for the known risks of the study to become manifest as harms. Benefits of such considerations may include enhanced subject satisfaction and cooperation, community acceptance, and improved data quality, among other desirable consequences. (shrink)

This article examines the clergy sexual abuse crisis in the Roman Catholic Church from an ethical point of view. The article uses the RRICC values model of ethical decision making (i.e., responsibility, respect, integrity, competence, concern) to review the behavior of Catholic bishops and other religious superiors as they have tried to manage clergy sex offenders and their victims. Hopefully, the recent press attention and resulting policy changes on these matters from the U.S. Council of Catholic Bishops will increase the (...) chances that future decisions will be ethical ones. (shrink)

This article examines the clergy sexual abuse crisis in the Roman Catholic Church from an ethical point of view. The article uses the RRICC values model of ethical decision making (i.e., responsibility, respect, integrity, competence, concern) to review the behavior of Catholic bishops and other religious superiors as they have tried to manage clergy sex offenders and their victims. Hopefully, the recent press attention and resulting policy changes on these matters from the U.S. Council of Catholic Bishops will increase the (...) chances that future decisions will be ethical ones. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

This article argues that we could improve the design of research protocols by developing an awareness of and a responsiveness to the social contexts of all the actors in the research enterprise, including subjects, investigators, sponsors, and members of the community in which the research will be conducted. “Social context” refers to the settings in which the actors are situated, including, but not limited to, their social, economic, political, cultural, and technological features. The utility of thinking about social contexts is (...) introduced and exemplified by the presentation of a hypothetical case in which one central issue is limitation of the probability of injury to subjects by selection of individuals who are not expected to live long enough for the known risks of the study to become manifest as harms. Benefits of such considerations may include enhanced subject satisfaction and cooperation, community acceptance, and improved data quality, among other desirable consequences. (shrink)

As out-of-hospital emergencies become more commonplace, so does the call for a “doctor in the house”. New York City paediatrician Mitchell Rubin has responded to numerous such crises over the past 25 years. He explores reactions on all sides of this peculiar physician–victim relationship, his growing concerns and fears, and possible reasons why many doctors hesitate to act. His thoughts and experiences instigate the discussion about the need for a universal system of Good Samaritan physician respondersWhile flying to Italy (...) last spring, the pilot’s voice came over the loudspeaker: “Is there a doctor on board”? How many times have I heard this request in the last 25 years? A passenger had fainted. As I began caring for her, the pilot asked me, “Should we take the plane down?”. Surprised to be given this responsibility, I took my best guess and answered “no”. After a stressful landing, while I gave oxygen to the prostrate woman, we were met by an ambulance on the tarmac. The woman was appreciative and gracious, the pilot scarcely offered thanks, and I began my vacation exhausted.Having been trained as a paediatrician, I have responded to nearly two dozen “Good Samaritan” scenarios, where a person was injured or became critically sick in a public setting. Perhaps I have had more than my fair share, but I wonder if this is an important and mounting phenomenon. With America growing older and more and more people with serious, chronic illnesses remaining active in the community, we should not be surprised to see increasing numbers of out-of-hospital emergencies. And, as this becomes more commonplace, I become less and less certain of the role I—and other physicians like me—should have.When I was young, cocky and fearless, the call to meet an emergency was exciting. Shortly after training, an …. (shrink)

In 2015, the major critical care societies issued guidelines outlining a procedural approach to resolving intractable conflict between healthcare professionals and surrogates over life-sustaining treatments (LST). We report our experience with a resolving conflict procedure. This was a retrospective, single-centre cohort study of ethics consultations involving intractable conflict over LST. The resolving conflict process was initiated eleven times for ten patients over 2,015 ethics consultations from 2000 to 2020. In all cases, the ethics committee recommended withdrawal of the contested LST. (...) In seven cases, the patient died or was transferred or a legal injunction was obtained before completion of the process. In the four cases in which LST was withdrawn, the time from ethics consultation to withdrawal of LST was 24.8 ± 12.2 days. Healthcare provider and surrogate were often distressed during the process, sometimes resulting in escalation of conflict and legal action. In some cases, however, surrogates appeared relieved that they did not have to make the final decision regarding LST. Challenges regarding implementation included the time needed for process completion and limited usefulness in emergent situations. Although it is feasible to implement a due process approach to conflict over LST, there are factors that limit the procedure’s usefulness. (shrink)

The National Center for Biomedical Ontology is a consortium that comprises leading informaticians, biologists, clinicians, and ontologists, funded by the National Institutes of Health (NIH) Roadmap, to develop innovative technology and methods that allow scientists to record, manage, and disseminate biomedical information and knowledge in machine-processable form. The goals of the Center are (1) to help unify the divergent and isolated efforts in ontology development by promoting high quality open-source, standards-based tools to create, manage, and use ontologies, (2) to create (...) new software tools so that scientists can use ontologies to annotate and analyze biomedical data, (3) to provide a national resource for the ongoing evaluation, integration, and evolution of biomedical ontologies and associated tools and theories in the context of driving biomedical projects (DBPs), and (4) to disseminate the tools and resources of the Center and to identify, evaluate, and communicate best practices of ontology development to the biomedical community. Through the research activities within the Center, collaborations with the DBPs, and interactions with the biomedical community, our goal is to help scientists to work more effectively in the e-science paradigm, enhancing experiment design, experiment execution, data analysis, information synthesis, hypothesis generation and testing, and understand human disease. (shrink)

Emotional arousal and negative affect enhance recall of central aspects of an event. However, the role of discrete emotions in selective memory processing is understudied. Undergraduates were asked to recall and rate autobiographical memories of eight emotional events. Details of each memory were rated as central or peripheral to the event. Significance of the event, vividness, reliving and other aspects of remembering were also rated for each memory. Positive affect enhanced recall of peripheral details. Furthermore, the impairment of peripheral recall (...) was greatest in memories of anger, not of fear. Reliving the experience at retrieval was negatively correlated with recall of peripheral details for some emotions (e.g., anger) but not others (e.g., fear), irrespective of similarities in affect and intensity. Within individuals, recall of peripheral details was correlated with less belief in the memory's accuracy and more likelihood to recall the memory from one's own eyes (i.e., a field perspective). (shrink)

ABSTRACTNew methods of calculating indices from the dot-probe task measure temporal dynamics in attention bias or fluctuations in attention bias towards and away from emotional stimuli over time. H...

We compared the ability of three different contextual models of lexical semantic memory and of a simple associative model to predict the properties of semantic networks derived from word association norms. None of the semantic models were able to accurately predict all of the network properties. All three contextual models over-predicted clustering in the norms, whereas the associative model under-predicted clustering. Only a hybrid model that assumed that some of the responses were based on a contextual model and others on (...) an associative network successfully predicted all of the network properties and predicted a word's top five associates as well as or better than the better of the two constituent models. The results suggest that participants switch between a contextual representation and an associative network when generating free associations. We discuss the role that each of these representations may play in lexical semantic memory. Concordant with recent multicomponent theories of semantic memory, the associative network may encode coordinate relations between concepts, and contextual representations may be used to process information about more abstract concepts. (shrink)

This book explores four interrelated themes: rethinking civic education in light of the diversity of U.S. society; re-examining these notions in an increasingly interconnected global context; re-considering the ways that civic education is researched and practiced; and taking stock of where we are currently through use of an historical understanding of civic education. There is a gap between theory and practice in social studies education: while social studies researchers call for teachers to nurture skills of analysis, decision-making, and participatory citizenship, (...) students in social studies classrooms are often found participating in passive tasks rather than engaging critically with the curriculum. _Civic Education for Diverse Citizens in Global Times_, directed at students, researchers and practitioners of social studies education, seeks to engage this divide by offering a collection of work that puts practice at the center of research and theory. (shrink)

This paper aims at exploring the relationship between corporate wrongdoing and CEOs’careers. We hypothesize that the managerial labor market does not punish CEOs of companies involved with wrongdoing. The analysis of data on 16 companies charged by the SEC supports this hypothesis.

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)